Special Cardinal Care Scenarios

Learn about unique Cardinal Care enrollment situations, such as leaves of absence or degrees conferred off cycle. 

Cardinal Care Coverage When You Confer Your Degree or Permanently Withdraw

Cardinal Care is an annual plan—that is, if you are returning to Stanford in the Autumn Quarter (and do not take steps to opt out of Cardinal Care by the applicable deadline) you’ll have coverage for the entire year and be charged accordingly. Similarly, if you enter Stanford in another quarter (and do not take steps to opt out of Cardinal Care by the applicable deadline) you’ll have coverage for the remainder of the plan year and be charged accordingly.

One exception to this rule applies to students who graduate at the end of Autumn Quarter or Winter Quarter. Students who plan to end their relationship with the University, through conferral of a terminal degree at the end of Autumn Quarter or Winter Quarter, may request to be taken off the plan at the end of the corresponding Cardinal Care coverage period; Dec. 31 for Autumn Quarter graduates and Apr. 30 for Winter Quarter graduates. To initiate a request, you must complete the Petition for Early Cancellation of Cardinal Care Health Insurance form and submit it to Vaden Health Center’s Insurance and Referral Office by the applicable deadline; Dec. 15 for Autumn Quarter graduates and Apr. 15 for Winter Quarter graduates.(Students who graduate at the end of Spring Quarter do not have the option to leave the plan early, and coverage remains in effect through Aug. 31.)

Another exception to this rule applies to students who intend to permanently withdraw from the university. To initiate a request to cancel coverage due to permanent withdrawal from the university, you must complete the Petition for Early Cancellation of Cardinal Care Health Insurance form and submit it to Vaden Health Center’s Insurance and Referral Office. Cancellation of coverage does not occur automatically in these instances and you must petition for cancellation at least 30 days prior to the last day of the month in which you want coverage to end. 

ServiceNow Link for the Petition for Early Cancellation

Accessing Care through Cardinal Care When No In-Network Provider is Available (10.27.25)

When you need health care, a key first step is to determine whether your provider is in the network used on the 2025-2026 Cardinal Care plan. Use the link(s) below to identify in-network care options inside California with the Blue Shield of CA PPO network, or to identify in-network care options outside California with the Cigna PPO network.  

• Search for CA providers (under "Plan Type" select "Blue Shield of California PPO Network")
• Search for providers outside of CA (under "Select a Plan" choose "PPO)
• 2025-2026 Wellfleet Provider Search Guide (for a step by step guide to find in-network care)

Cardinal Care: In-Network vs Out-of-Network Benefits

When you use an in-network provider for services, claims submitted by that in-network provider to the Cardinal Care plan are processed at an in-network benefit level. If you use an out-of-network provider, claims are processed at an out-of-network benefit level. Receiving services from an in-network provider may reduce your out-of-pocket cost share. 

Cardinal Care: Coverage When No In-Network Provider is Available

If an in-network provider is not available in a given service area to provide you with Medically Necessary health care services as defined under the Cardinal Care plan, you may be able to receive care from an out-of-network provider, and be responsible for cost share in an amount equal to the cost share the plan would have assigned for that health care service, or a similar service, if the care was provided by an in-network provider (see #11 below). 

Cautionary Note: In-network Hospitals may be staffed with out-of-network providers. Receiving services from an in-network hospital does not guarantee that all charges will be paid at the Cardinal Care plan in-network provider level of benefits. It is important to understand whether your physicians are in-network or not when you make an appointment or at the time of service.

Should you need non-urgent care when no in-network provider is available, and you can identify an out-of-network provider who can help you, follow the steps below:

1. Contact the Wellfleet Student / Cardinal Care Customer Service Team at 1.833.343.5338.
2. The Customer Service Representative will use the ‘Find a Doctor Tool’ (links provided above) to determine whether an in-network provider who can provide the service you need is available in your current location. The Representative will take your name, date of birth, Wellfleet Student ID #, and name of the school you attend and document the call in Wellfleet’s system.
3. The Representative will also review the Cardinal Care benefits to confirm the services being requested are covered.
   1. If the service is covered under Cardinal Care, and an in-network provider is available to provide that service, you can make an appointment with that provider, or the Representative can contact the provider to make an appointment for you.
   2. If the service is covered under Cardinal Care, and the Representative has confirmed that no in-network provider is available in your location to provide the service, the Representative will document that finding.
4. If you have the name and address of an out-of-network provider who can provide the service you need, you will be asked to supply the following information so the Representative can document it in Wellfleet’s system.

• Name of the out-of-network provider
• Address of the out-of-network provider
• NPI and/or Tax ID of the out-of-network provider (if available)
• Type/Speciality of the out-of-network provider
• Supporting documentation of the requested service (The Representative may ask you to email the details for the required service to them).

5. The Representative will inform the Wellfleet Clinical Team.
6. The Clinical Team Representative will review the type of service being requested and the location where the service is needed, and will confirm that no in-network provider is available. Once confirmed, they will enter a note in your Wellfleet record with approval for the service to be provided to you by the out-of-network provider, and will notify the Customer Service Representative who initiated the request.
7. The Clinical Team Representative will send a letter to you and to the out-of-network provider who was approved to provide the service. (NOTE: the Clinical Review process can take up to 4 business days*).
8. A note will be entered into the Wellfleet claim system so that claims submitted by the out-of-network provider will be processed at the Cardinal Care Plan in-network benefit level.
9. Wellfleet will cover charges for the service(s) up to the amount that is considered Usual and Customary (i.e., Usual and Customary coverage is based on what providers in the same location charge for the same service).  Since the provider is out-of-network for Cardinal Care, you may be held responsible by the provider for any amount charged that is above Usual and Customary.
10. All charges related to the approved services are subject to the Cardinal Care plan’s policy provisions and limitations in effect at the time service is rendered.

For questions regarding this process, contact the Wellfleet Student / Cardinal Care Customer Service Team at 1.833.343.5338.

*Certain aspects of the above process may vary according to state specific requirements and the location where the service is provided. 

Additional Health Insurance Considerations for Visiting Student Researchers (and Other Non-Matriculated Students)

Visiting Student Researchers are automatically enrolled in Cardinal Care and must follow instructions to acknowledge the Cardinal Care Enrollment Policy.  After completing the Cardinal Care Enrollment Policy in Axess, VSRs can submit a waiver request if they so choose through the process outlined here.

For VSRs starting in the first 60 percent of the quarter*

If you begin your appointment within the first 60 percent* (roughly seven weeks) of a given quarter, you are automatically enrolled in Cardinal Care retroactive to the start of the applicable coverage period, and the corresponding quarterly charge appears on your bill in Axess.

For VSRs starting after the first 60 percent of the quarter*

If you begin your appointment after 60 percent* of the quarter has passed, you are not automatically enrolled in Cardinal Care for that quarter (but will be the next). You must contact Vaden’s Insurance and Referral Office to arrange for coverage for the remainder of your entry quarter if you wish to be covered by Cardinal Care.

Early Termination of VSR appointment and Health Insurance

If you are enrolled in Cardinal Care and your appointment terminates prior to the end of the Autumn or Winter Quarter Cardinal Care coverage periods, you are eligible to request early cancellation of Cardinal Care. You can request early cancellation due to appointment termination by submitting a ServiceNow ticket prior to your appointment end date. Requests for early cancellation should be submitted by you (the VSR), not the host department administrator. You will remain enrolled in Cardinal Care for the entire plan year if you do not request early cancellation. If early cancellation is requested, Cardinal Care benefits will be terminated at the end of the Autumn Quarter insurance billing period (12/31) or the Winter Quarter insurance billing period (04/30).

_{*The 60% date of each quarter is noted in the Academic Calendar under the title Term Withdrawal deadline.}

Because VSR appointments start throughout the academic year, the timing of the being able to acknowledge the Cardinal Care Enrollment Policy in Axess, and submitting a waiver request may differ compared to a student enrolled in a degree program at Stanford University.  

VSRs may experience the following due to the timing of their appointment start date:

• Inability to view or acknowledge the Cardinal Care Enrollment Policy in Axess until their appointment start date
• Denied access to waiver portal through Academic Health Plans until their appointment has started AND their SUNet has been created 

VSRs will still have an opportunity to submit a waiver request during the month their appointment starts at Stanford, even if it is after their entry quarter waiver deadline.

For Example: If a VSR appointment begins on April 1, they will be automatically enrolled in Cardinal Care with the start of the Spring Quarter insurance billing period.  Since the VSR appointment begins after the March 15 Spring Quarter entry student waiver deadline, the VSR will still be allowed to submit a request to waive Cardinal Care during the month their appointment begins (April).  

Waiver requests will still be reviewed to confirm that the alternative policy meets minimum waiver requirements set by Stanford University (VSRs are only required to maintain health insurance coverage for the length of their appointment at Stanford).

VSRs visiting with a J-1 visa must also meet health insurance requirements set by the Department of State.

More information about Visiting Student Researchers can be found here

Additional questions can be directed to the Vaden Insurance and Referrals Office through Service Now ticket.